The reality of two people with the same chronic illness in SA is vastly different. One person may depend on a continuous blood glucose monitor, which sends real-time results to their smartphones, helping them stay within a safe range. The other may test sporadically with strips – if they’re available – relying on symptoms to guide care. One may use an easy-to-use pen for their insulin injections, while another may use a syringe and a vial – less convenient, less practical, and less safe.Both are living with diabetes. One person benefits from innovation. This stark contrast illustrates a widening innovation divide – a gap between what is scientifically possible and what is accessible in the public health system. It is a divide that has life-and-death consequences.Effective management prevents complications and reduces the long-term burden on the healthcare systemThe past decade has brought remarkable advances in diabetes treatment. Newer classes of medicines – such as glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT2) inhibitors – do more than lower blood glucose; they reduce the risk of heart disease, kidney failure, and premature death.Similarly, technologies such as insulin pens and continuous glucose monitors empower people to monitor and manage their condition more effectively. In countries with widespread availability of these tools, diabetes care has been transformed, improving outcomes and quality-of-life. Yet, these innovations remain beyond the reach of millions of South Africans. Income or medical coverage is the main factor that determines access to new drugs and equipment. When relying on public health care, those who are ill often have limited treatment options. They may be restricted to less effective older therapies. These are not failures of science; they are failures of equity – and of a health system that remains more reactive than proactive, slow to embrace innovation, to the detriment of thousands of South Africans.SA has one of the highest diabetes prevalence rates in Africa, with an estimated 4.3-million people living with the condition. Undiagnosed diabetes is among the most common causes of death. The economic cost is immense, driven by hospitalisations, disability, and lost productivity.Investing in modern, evidence-based and personalised diabetes care is therefore not just a moral imperative – it is sound public policy. Effective management reduces long-term costs to the healthcare system and prevents complications. In this sense, innovation is not an expense; it is an investment in life and productivity.The 2023 Diabetes Summit underscored this point, recommending the introduction of new drugs and devices in the public sector to allow clinicians to tailor care to each patient’s needs. This is a realistic, achievable step that can help improve outcomes and reduce the equity gap. Innovation must be translated into access through collaboration and commitment. Civil society organisations are essential in this effort. Government, academia and civil society must all work together to create a system which ensures that modern diabetes care is affordable and sustainable. These partnerships show the power of collective actions. The Diabetes Alliance brings together advocates and healthcare professionals to inform policy. The Healthy Living Alliance addresses environmental and social factors that influence non-communicable diseases outcomes. When coalitions unite around shared goals – whether to expand access to treatment, promote healthier food environments, or improve health literacy – progress follows.From November 11 to 13, the Third Biennial Diabetes Summit will be held at the Radisson Hotel & Convention Centre in Johannesburg under the theme “Innovate for Impact: Transforming the Future of Diabetes in South Africa”This meeting will bring together leaders in government, academia and industry to discuss how innovation can enhance prevention, policy and care. This is a timely reminder of the fact that innovation only serves its purpose when it reaches the people who need it the most. SA has the scientific expertise and policy frameworks to lead the way for equitable diabetes care. Innovation has provided us with extraordinary tools that can prevent suffering and save life. The next step – and the true measure of progress – is ensuring that these tools are accessible to everyone, regardless of income, geography, or circumstance.Because in the end, innovation without access is inequality, and inequality undermines our vision of a long and healthy life for all South Africans.Dr Piotie is the chairperson of the Diabetes Alliance SASowetan
2025-10-28 10:56:14
Effective diabetes care must be accessible to all
